title: Significance of semiquantitative assessment of preformed donor-specific antibody using luminex single bead assay in living related liver transplantation.
abstract: OBJECTIVE
  To analyze the risks of preoperatively produced donor-specific antibody (DSA) in liver transplantation.
  
  
  METHODS
  DSA was assessed using direct complement-dependent cytotoxicity (CDC) and anti-human globulin- (AHG-) CDC tests, as well as the Luminex Single Antigen assay. Among 616 patients undergoing blood type identical or compatible living donor liver transplantation (LDLT), 21 patients were positive for CDC or AHG-CDC tests, and the preserved serum from 18 patients was examined to determine targeted Class I and II antigens. The relationships between the mean fluorescence intensity (MFI) of DSA and the clinical outcomes were analyzed.
  
  
  RESULTS
  Patients were divided into 3 groups according to the MFI of anti-Class I DSA: high (11 patients with MFI > 10,000), low (2 patients with MFI < 10,000), and negative (5 patients) MFI groups. Six of 11 patients with high Class-I DSA showed positive Class-II DSA. Hospital death occurred in 7 patients of the high MFI group. High MFI was a significant risk factor for mortality (P = 0.0155). Univariate analysis showed a significant correlation between MFI strength and C4d deposition (P = 0.0498).
  
  
  CONCLUSIONS
  HLA Class I DSA with MFI > 10,000 had a significant negative effect on the clinical outcome of patients with preformed DSA in LDLT.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Kimiko
authors.initials: K
authors.lastname: Yurugi
authors.forename: Rie
authors.initials: R
authors.lastname: Hishida
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tsuji
authors.forename: Eiji
authors.initials: E
authors.lastname: Ashihara
authors.forename: Aya
authors.initials: A
authors.lastname: Miyagawa-Hayashino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
authors.forename: Taira
authors.initials: T
authors.lastname: Maekawa
authors.forename: Hironori
authors.initials: H
authors.lastname: Haga
authors.forename: Sinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002648:Child; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D015395:Histocompatibility Antigens Class I / Q000235:genetics / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000235:genetics / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007118:Immunoassay; D007223:Infant; D007518:Isoantibodies / Q000032:analysis* / Q000276:immunology; D016031:Liver Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis
chemical_list: D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D007518:Isoantibodies